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Altitude sickness prophylaxis — DTM&H MCQ

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EasyTravel MedicineAltitude sickness prophylaxisDTM&H

A travel clinic nurse is advising a 25-year-old man planning to climb Kilimanjaro (5,895 m). He has no altitude experience. What is the most appropriate pharmacological prophylaxis for acute mountain sickness?

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Correct answer: E — Acetazolamide 125 mg twice daily starting one day before ascent

Acetazolamide is first-line pharmacological prophylaxis for AMS. It works as a carbonic anhydrase inhibitor, promoting bicarbonate diuresis and causing a metabolic acidosis that stimulates ventilation. Starting 1 day before ascent and continuing for 2-3 days after reaching maximum altitude. Dexamethasone is used for treatment of severe AMS or HACE, not routine prophylaxis. Nifedipine is for HAPE prevention in susceptible individuals. Gradual ascent (no more than 300-500 m elevation gain per day above 3,000 m) remains the most important preventive measure.

Reference: UKHSA; Wilderness Medical Society Guidelines